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sciatica

Pain down the leg, which is caused by irritation of the main nerve into the leg.

Neurosciences

Nerve Root Injection

Contact: (0191) 256 3347 - Neuroradiology

IntroductionShow [+]Hide [-]

Why do I need this injection?

You have sciatica in the leg or brachialgia in the arm caused by a trapped nerve in the back or neck. The cause of the trapped nerve can be due to a narrowed exit hole (foraminal stenosis), slipped disc, or by a slipped back bone (spondylolisthesis). Injecting around the nerve root just as it leaves the spine can help relieve the pain in the affected limb.

What is the aim of the treatment?

The aim of a nerve root injection is to give local anaesthetic and a long acting steroid close to the nerve root as it leaves the spine. This produces an anti-inflammatory effect and can relieve the arm or leg pain.

Nerve root injections can be used in two ways:

As a diagnostic tool to confirm whether the trapped nerve root is the cause of the limb pain.

As a treatment for the pain repeated as necessary.

Before your procedureShow [+]Hide [-]

About your appointment

The procedure is done as an outpatient appointment. You will be in the department for about 1–1½ hours in total.

We advise that you do not drive for 24 hours following the injection. You should therefore arrange alternative transport.

You can eat and drink as normal before the procedure.

You should take your usual medications, however if you are prescribed Warfarin, you must telephone to let the nursing staff know before the appointment date.

If you are diabetic, you do not need to let us know in advance.

What happens when I arrive at the hospital?

Please report to the admissions office at the entrance to the main corridor of Newcastle General Hospital and then continue to the reception desk in Neuroradiology (which is on the ground floor of the Regional Neurosciences Centre). A radiology nurse will come to meet you.

You will be asked to change into a hospital gown and pyjama bottoms and the nurse will complete a checklist.

The radiologist will explain the procedure to you, answer your questions and ask you to sign a consent form. A pen mark will be made on the area to be injected.

During your procedureShow [+]Hide [-]

How is the injection performed?

You will be asked to lie face down on the x-ray couch, whilst the area to be injected is cleaned with antiseptic solution.

The skin numbed with some local anaesthetic - this stings a little at first.

Using x-ray guidance, a fine needle is inserted into the exit hole of the nerve root suspected to be the cause of the pain. A small amount of local anaesthetic and the long acting steroid (depot steroid triamcinolone) is then injected around the nerve root.

How long will the pain relief last for?

Pain relief varies for each individual. Your pain may:

be relieved completely and not return

be reduced for several weeks and then return, but is not as bad

be reduced for several weeks but return as bad as it was.

After your procedureShow [+]Hide [-]

What happens after the injection?

Following the injection, you will be asked to sit on the side of the x-ray couch and then to stand. You will then be given a seat back in the day unit for approximately 30 minutes and should then be able to go home.

You may notice that your leg or arm feels slightly warm and numb for a few hours afterwards.

You will be given a pain chart to complete at home. The radiology nurse will explain it to you. We will ask you to send a completed copy to the radiologist who carried out the procedure and to take a copy to your outpatient appointment with the referring consultant.

Pain relief may occur in the following ways:

Immediate relief.

Pain relief starting within 12 – 24 hours.

No change for several days and then a slow improvement over for several weeks.

How do I get my results?

The consultant who referred you for the procedure will arrange for you to have an outpatient appointment to review the results

Who do I contact if I have any problems?

Please contact a Neuroradiology nurse

Monday to Friday 8:30am to 5:00pm

Telephone: (0191) 256 3347

Outside these times, please contact your GP.

Side effects, risks and complicationsShow [+]Hide [-]

What are the side effects of the treatment?

There may be a temporary numbness in the arm or leg. This usually wears off in a few hours.

What are the risks and complications of the treatment?

Soreness or bruising where the injection was given. This usually settles in a few days.

Infection - Infection risks are minimised by performing the procedure under sterile conditions.

No pain relief - the commonest complication would be that the treatment did not help the nerve root pain in the arm or leg.

Like all x-ray machines the one used during the nerve root injection produces x-rays. Modern equipment is designed to keep the dose to patients as low as possible. Your referring consultant will have decided that the benefit of having the nerve root injection is greater than the risk of the small dose of radiation. However, if you think you may be pregnant it is very important that you tell the radiographer before the procedure.